Homestead_Martin (4) SIAM FORM'3,010C t',NI TRFATLAEA WORM 73-IA
.APPROVED BY STATE Bn'RO M AnnOUNR.9x IRFXAIBED BY THE DEPARnmVT OF LOCAL tgATR0MFA7 FINANCE M 6-1.1:2241
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and retried couples are limited to onc homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ester for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings_This information will be kept confidential and ran only be acs-wad by authorized county officials.The Ds-penmen!of
Local Government Finance will use this information to crow tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Martin, Clarence JlTabetha B
H4 13ox 56
Princeton IN 47670
1037
Clarence J Martin
330 S Gibson State Parcel Number Legal Description
PRINCETON IN 47670-2114
IlllIIIilrllIIll IttrlIIlllltllltttlltttllllttlrrllllllItlItlll 26-12-07-401-000.278-028 019-00278-00 PT SE7-2-10.17 AC
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
qL r.0.K,e.n. 2T, eJ�LI rnaLo� 4n
�g Address(number and street,city,stale,and ZIP code) Came as property address
�J�0 • G--ton S -Poi ALQ'k-on_ Tr■ (-(-7 Q7 a
Spouse First Middle Last
GVet 13egpcky Le rtct.. MQNi-In
Mailing Address(Number and street,city,state.and ZIP code) 9-Same as property address
t t
1—,) C3 5 , ‘ SD S� Pin x n C.e-1/2--0 ti Zfrt Y 76 7D
/ ..___,_____ --_ _
-_ _
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signs . Date
CLAli�9 FOR HOMESTEAD PROPERTY TAX F Y�
CREDIT/STdNDARD DEDUCIION � Cto �
��u� c�„� APR
Prearbed by IM1e DeperNieni aF Laal Governnent Fvmim
INSTRUCTIONS: See ieverse side Iw filing insbvtSons. �
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i(we) �rnr mat o� a� t� my or r�nar�n. zo
I ) ocaipied as av prcidpal plare M resider�ce the fo0owirg esaited rPal poperty (or whid� a HunesEead Property T�e Cwedit is he2by daimed:
I(We) owr�ed ❑ Are buyug unde� mntrad
Have a benefidal mfare� m the entity tliat is liade Gor ihe property faxes m ihe property and tliat owns ihe {xoperty or is buy"u�g urMer a contract
- CONTitIlCLRECORDED:"t'�` ' tisi.�'.� ., : '1��i i '4 I..�_".`y�.�'.��v:
tt buyig om m�traC. Fee Simpe owrefs iame �.
RamderS of6ce where w6ad is racoded Remrd numhm Pege
Tumsldp
Pa�tel nariba/ I L 7 / p0op� ,/'� —�T : I is �he
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t"�/
II arry partion 1�(a resderdial strucRUe w fhe lad nal mmee�r9 ona 1) aoe tlial inrt�Qmlety wrtm�
d Ne yLimA to pro�qca uimrtie.
�n � //X ��/ / � / � / – 6�(..CJ.li3 /1J � FJ(i
... .'., , . ,.. ., . _.; ,... -�. . �`:PROPEIiTYOWNm
Counry 7avnship
I hereby certify tlie above Sfatert�enis are true. carted and tortplete.
(nur�s ens ffia/s't� ���: s�. ZIPcoOe) �L (�
_ � �� � lT \ �SO�^ � ! Y1� l 11C'i
Counry
of daimaa
alpraperry LJ NobikHort�e(I.C.61.1-n �
9 USEd 1O GIOdILB IILp118. dl91]�B i�1B IA8 2IId POl�10l1
. . .• ' : ;, . : �: S .; �• 7i�JE.TAX . � /�SSFD VALUE F100�STEl1D� 'C: ' MON�ESID6JML`%��Y�'ye
, ,t. - � , �OR USE ONLY_ ' n VALUE;; �AT 100%OF TiV ` '.. VALUE, t s .� '::^t.e;,., i`.`3' V/1LUE `r�;R...'��„'1„v�
Larw not e�ng t(one) ave irm�mey ` r' h't�(,j' '�a�s�tr r`�: r���'•.`
siaroundvg residential impo�emenls. ��� ,va�'� ����i r��'%r} f� `���� ;`��s�?i��`�w�
OU�a lard �Z� . ���,r_, � .
Tdsl land (I'are 1 pdu 1'ure � ig1
�S � Sq'°(ir c... i �.���w;t
Resdential miprovements annrn,aly �� (4) > �rc '�`-��,1 a, y }"' ..,rt�t �`;'�,'�
Assessed AAadle / MarpRa�heed Fiort�e � e f a I�� �<��€ �:T�.i��a, a'�. �"`j �"•
`� �5� ° .� �.. �s_ ;`:s�+ �, v z� "4�+".a'
� ,r:�r
omerunprovm�ents .. (s) .-,�`�..
Tdal vnP�ovemenls (fire 4 Wough 6ne 6� i7�
Ti�l ralue (I'ore 3 pha Gne � (g)
I hereby cerGfy the above 's We. mfeeY. and 39�aa oflwaesau Da1a sig�ed
wnpkte-
Maifymg a0ian - Sigrehae of Audc� Data signed
� - � � � ;STANDARD:DEDUCTIOiiALLOYYANCE ���"` � .ti'-;; � >b,,. ;=e+��#.`;i;r;i
� 20_Pay20_
Lesser of 12 Homestead
Valuation or 535.000 S
Si�a4ae of Audtw � s��